Celecox

Composition:
Each capsule contains:
Celecoxib                        200 mg

Properties :
Celecox capsule contains contains celecoxib, a potent non steroidal antiinflammatory drug related to alkanones, a new group that prferentially inhibits cyclooxygenase-2 (Cox-2) currently available NSAIDs non selectively inhibit cox -1 & cox -2.

Mechanism of action :

Cyclo-oxygenase is the first enzyme of prostaglandin synthesis. It converts arachidonic to the unstable intermediates PG. G2 and PG. H2.
There are two forms of Cyclo-oxygenase (Cox), the first form is cox-1 which is a constitutive isoform found in blood vessels, stomach and kidneys. Cox-2 is induced in setting inflammation by cytokines and inflammatory mediators. Celecoxib preferentially inhibits cox-2, it has greater selectivity of cox-2 versus cox-1.
This imparts celecoxib a very low incidence of ulcerogenic effect and causes less incidence of renal failure, in addition to its potent anti-inflammatory and analgesic effects.

Pharmacokinetics:
The drug is well absorbed from the gastrointestinal tract, it is highly protein bound. It attains peak concentration with 3 hours after oral administration and is excretd via urine & stool.

Indications:
Rheumatoid arthritis, osteoarthritis, including swollen joints. It treats arthritis pain and inflammation, improves stifness, functions  as walking, bending and moving.
Containdications:
- Known sensitivity to celecoxib.
- Celecox should not be given to patients who have demonstrated allergic type reactions to sulfonamides.
- Patients with preexisting asthma.
- Patients with advanced kidney disease.
- Pediatric patients below 18 years.


Pregnancy and lactation :
There are no controlled studies that permit the use of this medication in pregnancy or lactation.

Drug-drug interactions:
- General celecoxib metabolism is predominately mediated via Cytochrome P450 2C9 in the liver, co-administration of celecoxib with drugs that are known to inhibit 2C9 should be done with caution.
- Patients on Lithium treatment should be closely monitored when celecox is introduced or withdrawn.
- This medication does not interfere with pharmacokinetics of methotrexate or warfarin, it does not alter prothrombin time among those redeiving warfarin.
N.B. Unlike aspirin, this medication has no effect on platelet activity.

Side effects:
Gastrointestinal manifestations such as dyspepsia, nausea, diarrhea.
GI bleeding perforations and ulcers may occur at any time with less incidence of any other NSAID, allergic reactions, headache, upper respiratory tract infection.

Warnings :
- All Cox – 2 medicines as well as NSAIDs can cause fluid retention and swelling.
Fluid retention can be a serious problem if the patient has high blood pressure or heart failure.

- Serious gastrointestinal toxicity such as bleeding, ulceration and perforation of the stomach, small intestine or large intestine can occur at any time with or without warning symptoms.

- Serious allergic skin reactions may also happen with Cox – 2 medicines and other NSAIDs such as swelling of the face, lips, tongue or throat, these allergic reactions may cause problems with breathing, swallowing and wheezing.
- Should be prescribed cautiously to patients with prior history of ulcer disease or GI bleeding.
- Patients with pre-existing kidney disease.
- Patients with considerable dehydration.
- Patients with signs of liver dysfunction or whenever abnormal liver test have occurred should be monitored carefully, if systemic manifestation occur e.g. eosinophilia, rash, Celecox should be discontinued.
- Long term administration of NSAIDs results in renal papillary necrosis.


Dosage and administration :
Osteoarthritis: For relief of pain and inflammation of osteoarthritis, the recommended oral dose is one capsule per day.

Rheumatoid arthritis: For relief of pain and inflammation of rheumatoid arthritis, the recommended oral dose one capsule twice per day.

Package :

Boxes each contains 10 & 5 capsules.

 

THIS IS A MEDICAMENT
Medicament is a product, which affects your health and its consumption contrary to instructions is dangerous for you. Follow strictly the doctor’s prescription, the method of use and the instructions of the pharmacist who sold the medicament.
- The doctor and the pharmacist are the experts in medicines, their benefits and risks.
- Do not by yourself interrupt the period of treatment prescribed.
- Do not repeat the same prescription without consulting your doctor.
- Keep all medicaments out of reach of children.

Council of Arab Health Ministers, Union of Arab Pharmacists.